Objective To determine the utility of diffusion-weighted magnetic resonance imaging ( MR DWI ) in detecting tumor necrosis with histological correlation after neoacljuvant chemotherapy. Methods Conventional MRI and DWI were obtained from 36 patients with histological proven esteosarcoma. Magnetic resonance examinations were performed in all patients before and after 4 cycles of preoperative neoadjuvant chemotherapy. Apparent diffusion coefficients (ADC) were calculated. The degree of tumor necrosis was assessed using the histological Huvos classification after chemotherapy. T-test was performed for testing changes in ADC value between the 2 groups. P value less than 0. 05 were considered as a statistically significant difference. Results The differences in ADC between viable [ (1.06±0. 30) ×10-3mm2/s ] and necrotic [ (2. 39±0. 44 )×10-3mm2/s] tumor were significant (t= 3. 515,P<0. 05). Changes in ADC value was greater in good responses to neoadjuvant chemotherapy than in poor responses, the ADC value in good responses was increased from (1.18±0. 19)×10-3mm2/s to (2. 27±0. 20)×10-3mm2/s, the corresponding value in poor responses was increased from (1.45± 0.11)×10-3mm2/s to (1.83±0. 16)×10-3mm2/s, There was significant difference in changes of ADC values between good responses and poor responses ( t = 4. 981, P < 0. 01 ). Conclusion Diffusion-weighted MRI permits recognition of tumor necrosis induced by chemotherapy in osteosarcoma. DWI is correlated directly with tumor necrosis. They have potential utility in evaluating the preoperative chemotherapy response in patients with primary osteosarcoma.

Acrocephalosyndactylia ; diagnosis ; genetics ; therapy ; Female ; Humans ; Infant

In order to discriminate the crude and sweated Dipsaci Radix correctly and rapidly, the crude and sweated Dipsaci Radix were scanned by the NIR spectrometer, and an identifying model was developed by near infrared spectroscopy combined with principal component-Mahalanobis distance pattern recognition method. The pretreated spectra data of 129 crude samples and 86 sweated ones were analyzed through principal component analysis (PCA). The identifying model was developed by choosing the spectrum for 9 881.46-4 119.20 cm(-1) and "SNV + spectrum + S-G" to the original spectral preprocessing with 14 principal components, and then was verified by prediction set, identifying with 100% accuracy. The rapid identification model of the crude and sweated Dipsaci Radix by NIR is feasible and efficient, and could be used as an assistant means for identifying the crude and sweated Dipsaci Radix.
Chemistry, Pharmaceutical ; methods ; Dipsacaceae ; chemistry ; Plant Roots ; chemistry ; Principal Component Analysis ; methods ; Quality Control ; Spectroscopy, Near-Infrared ; methods

Objective To report clinical study of diabetic foot with microsurgical treatment.Methods 32 cases basing on physical treatment underwent operation which included reconstruction of vessel under DSA and flap transfer and relaxation of nerves.Results 8 eases were examined with DSA after operation,it showed that the bypass grafts were unobstructed and the distal blood were improved;All flap were lively. Conclusion The ulcer of the patients with diabetic foot was closed early and the blood supply of the limb have been reconstructed by microsurgical treatment,it can not only avoid amputation or lower the limb amputation level,but also improve the life quality of patients and obtain social benefit.

Objective To report a 33-year-old man with post-headache stroke-like episodes,with whom ischemic changes were found in basal ganglia and occipital-temporal lobe and muscle biopsy revealed abnormal mitochondrial structure and function without regular mutations detected in mtDNA.Methods Gene chip technique was used to detect the mutation of whole sequence of mtDNA,and direct sequencing technique was used to confirm the mutations.Results Three mutations were found.A new mutation in the mitochondrial cytochrome C oxidase subunit 1 (MTCO1),a T→C transition at nucleotide position 6253 resulted in conservative methionine transferring to threonine.His mother also held the mutation,which was not found in 98 control samples.So T6253C was considered the nosogenetic mutation.Conclusion This is the first time to report a mutation in MTCO1 responsible of MELAS.

Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands,then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method.Based on the observed data.We selected five suitable cases,in which the opposi- tion function was lost,and then applied the new operation on them with partial transplantation of pectoralis mi- nor muscle anastomosed vessels and nerves according to the results of anatomic study.The follow-up study was conducted to observe the functional recovery of opposition of the thumb.Results The main results can be summarized as follows.First,the anatomical position of pectoralis minor muscle was stable,and every peetoralis minor muscle was provided with self-sustaining artery,vein and nerve.The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation.Second,follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully.The muscle strength in all five cases re- covered to level four or higher.The shape of palm eminence was satisfactory.Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application.The function of opposition of the thumb reached the satisfacto- ry requirement after the operation.So,the new surgical method can achieve better results than other existing operation methods.

OBJECTIVETo assess the methodology and report quality of systematic evaluation and Meta-analysis of acupuncture and moxibustion in China.

METHODSRetrieve CBM, CNKI, WF and VIP database, collect data from the information system established by Epidata 2.1, assess the methodology and report quality by using the QQAQ and QUOROM, calculate the percentage of adequate rate.

RESULTSThirty-eight reviews, including twenty six systematic evaluation and twelve Meta-analyses, met the enrolled criteria. Twenty-two kinds of diseases and six diseases systems were included. The methodology quality scores were generally low (3.34 +/- 1.44). The causes of the problems were insufficient literature resource, bias in data collections and inaccurate merging methods. The report quality was relatively low in abstracts, methods, trial flow, introduction and data merging.

CONCLUSIONThe amount of literatures on systematic evaluation and Meta-analysis of acupuncture is gradually increasing from 2002. However, the quality control is not ideal. It is important to improve the methodology and report quality.

Acupuncture Therapy ; methods ; China ; Moxibustion ; methods

OBJECTIVETo investigate the protective effect and mechanism of Shenqi Compound on diabetic angiopathy modeled rats.

METHODSTotally 18 SD rats were randomized into 3 groups, i.e., the normal control group, the diabetic mellitus (DM) group, and Shenqi Compound group, 6 in each group. The DM rat model was established by feeding high-fat diet (to induce hyperlipidemia) +intraperitoneal injection of small dose streptozotocin (STZ). Shenqi Compound was given to rats in the Shenqi Compound group at the daily dose of 2 g/kg. Equal volume of normal saline was given to rats in the model group and the normal control group by gastrogavage. All treatment was lasted for 12 weeks. Then 2-D and ultrasonic integrated backscatter technique were used to evaluate structural and functional changes of abdominal aorta in the progression of diabetic macroangiopathy. The fibrosis degree of the aorta vessel and myocardium capillaries were observed by using HE and Masson trichrome staining. The tension of the aortic vascular ring was determined. The transforming growth factor beta (TGF-beta) mRNA expression was detected by real time PCR (RT-PCR). The protein expression of TGF-beta, collagen I, collagen III, connective tissue growth factor (CTGF), and phosphorylation P38 MAPK were detected by Western blot.

RESULTSCompared with the normal control group, abdominal aortic systolic inner diameter, diastolic inner diameter, Peterson elastic modulus, stiffness index, and backscatter integral significantly increased; the rangeability of integral backscatter and the extension coefficient of cross section significantly decreased in the DM group (all P < 0.05). After 12 weeks aforesaid indices were obviously improved in the Shenqi Compound group (P < 0.05). Results of HE and Masson staining showed that the fibrosis degree of the aorta vessel and myocardium capillaries was obviously alleviated in rats of the Shenqi Compound group (P < 0.05). Results of the aortic vascular ring tension showed that acetylcholine induced vasodilatation and maximum diastolic percent were obviously elevated in the Shenqi Compound group (P < 0.05). Compared with the normal control group, the mRNA expression of TGF-beta, and the protein expression of TGF-beta, collagen I, and collagen III, and phosphorylation of P38 MAPK all significantly increased in the DM group (P < 0.05). Compared with the DM group, the mRNA expression of TGF-beta, and the protein expression of TGF-beta, collagen I, and collagen III, and phosphorylation of P38 MAPK all decreased (P < 0.05).

CONCLUSIONSShenqi Compound could effectively improve the arterial function in diabetic marcoangiopathy and microvascular dysfunction. The mechanism might be due to the down-regulating the expression of TGF-beta, and further suppressing the phosphorylation of P38 MAPK, reducing the synthesis of collagen I and collagen III, therefore, ameliorating arterial and myocardial interstitial fibrosis.

Animals ; Collagen Type I ; metabolism ; Collagen Type III ; metabolism ; Diabetes Mellitus, Experimental ; drug therapy ; Diabetic Angiopathies ; prevention & control ; Drugs, Chinese Herbal ; pharmacology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo summarize experience of using screws and cement to rebuild tibial bone defect in primary total knee arthroplasty (TKA) and to discuss the relationship between the number of required screws and the severity of tibial bone defects.

METHODSFrom July 2009 to May 2015, 34 patients (40 knees) with varus knees underwent TKA, and the screw and cement technique was used to rebuild medial tibia plateau during operation. There were 8 males (8 knees) and 26 females (32 knees), and the average age was (65.00 +/- 7.25) years old (ranged,55 to 82 years old). One to 6 screws were used in each case. Extension stems were used in 2 cases (4 and 5 screws was used respectively). The area percentages of the bone defects measured as defect area/tibia plateau area, depth of each defect, the number of screws needed in each case, were all used to determine the relationship between the number of screws and the area percentage in certain depth of bone defect by statistic methods, as well as the relationship between screw number and defect depth.

RESULTSAll the patients were followed up and the average duration was 24 months (ranged, 1 to 72 months). The average preoperative HSS score was 43.33 +/- 6.11 (ranged, 32 to 51 scores). Whereas the average postoperative HSS score was 92.15 +/- 4.64 (ranged,83 to 96 scores). The preoperative individual scores including pain, function, activity, nuscle strength, flexion deformity and stability were all improved compared with preoperation,and the differences were statistically significant. All the patients received normal alignment postoperatively, femoraltibial angle was improved from (167.00 +/- 6.39) degrees preoperatively to (175.00 +/- 2.69) degrees postoperatively, the tibial angle was improved from (78.09 +/- 4.51) degrees preoperatively to (88.75 +/- 1.24) degrees postoperatively. Both area percentage and depth of bone defect in a fitting Ologistic model had a significant statistical relationship with the screw number, and a rectangular coordinate system could be formed according to the relationship.

CONCLUSIONScrews and cement technique is a simple, safe and convenient method to rebuild tibial bone defects in primary TKA and its short-term and midterm effect are both reliable. During opera- tion, according to the rectangular coordinate system, the screw number needed in the operation can be inferred form th area and depth of tibia defect, which could have a guiding function in surgery.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; instrumentation ; methods ; Bone Screws ; utilization ; Female ; Fracture Fixation, Internal ; Humans ; Knee Injuries ; surgery ; Knee Joint ; surgery ; Male ; Middle Aged ; Tibia ; surgery

Objective To evaluate the value of CT guided percutaneous transthoracic needle biopsy (PTNB) for the diagnosis of lung ground‐glass opacity (GGO) with a Meta‐analysis .Methods Relevant English and Chinese language studies were searched on the PubMed ,EMBASE ,EBSCO ,OVID ,CNKI ,CBM ,VIP and WANFANG databases ,respectively .Data were calculated with software of Stata 12 .0 and Meta‐Disc 1 .4 .Results 6 of 82 retrieved studies were included (n=341) .The pooled sensitivity ,specifici‐ty ,LR+ ,LR- ,DOR ,AUC and 95% CI were 0 .92(0 .86-0 .95) ,0 .98(0 .85-1 .00) ,49 .03(5 .72-420 .18) ,0 .08(0 .05-0 .15) , 586 .24(65 .18-5 272 .83) and 0 .99(0 .98-1 .00) ,respectively .Conclusion CT guided PTNB can be used as one of the primary examination modalities for lung GGO with moderate sensitivity and specificity .